免疫检查点抑制剂相关的血管炎和多肌痛类风湿症:一个病例系列和系统审查
Aaron Teel1, Adrian Grebowicz2, Yuliya Lytvyn3
1Michael G. DeGroote School of Medicine, McMaster University, 50 Charlton Ave E, St Joseph's Hospital, Fontbonne Building, Hamilton, ON, Canada. aaron.teel@medportal.ca.
BMC rheumatology
|October 2, 2025
概括
免疫检查点抑制剂 (ICI) 相关的血管炎和多发性肌痛类风湿症 (PMR) 尚未得到认可. 葡萄糖皮质类药物有效治疗这些疾病,但继续或重新启动ICI的安全性仍不清楚.
科学领域:
- 类风湿病学 类风湿病学
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
背景情况:
- 免疫检查点抑制剂 (ICI) 可以引起与免疫相关的不良事件 (irAEs).
- 与ICI相关的血管炎和多发性肌痛风湿症候群 (PMR) 已被认为是irAEs.
- 这些ICI诱导条件的特征需要进一步阐明.
研究的目的:
- 描述ICI血管炎和ICI-PMR的临床特征.
- 分析这些疾病的治疗结果.
主要方法:
- 对MEDLINE和Embase的系统审查 (至2023年7月).
- 包括加拿大学术中心的当地案例系列.
- 鉴定和分析了144例患者病例 (130例来自审查,14例来自病例系列).
主要成果:
- 73名患者患有ICI血管炎,71人患有ICI-PMR.
- 95%的患者接受了葡萄糖皮质类药物,17%接受了DMARDs.
- 持续的ICI显示了血管炎的混合结果;持续的ICI缓解的ICI-PMR病例.
结论:
- ICI-血管炎和ICI-PMR是未被认可的ICI并发症.
- 葡萄糖皮质类药物是这两种情况的有效治疗方法.
- 需要进一步的数据继续或重新启动ICI在irAEs后的安全性.
相关概念视频
Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
492
The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
492
Myocarditis III: Medical Management
175
Myocarditis: Comprehensive Medical ManagementMyocarditis, the heart muscle inflammation, requires a comprehensive medical management strategy that addresses the underlying cause, provides supportive care, manages symptoms, and reduces cardiac workload.Infections and Autoimmune CausesAdminister appropriate antimicrobial therapy when an infectious agent causes myocarditis. For instance, penicillin treats infections caused by Group A Streptococcus. In cases where autoimmune processes are...
175
Pericarditis III: Medical Management
313
The primary objectives of managing pericarditis are to determine the underlying cause, provide effective therapy for treatment and symptom relief, and promptly detect signs and symptoms of cardiac tamponade. The following outlines the essential aspects of medical management for pericarditis:ObjectivesDetermine the Cause: Identifying the underlying cause of pericarditis is crucial for targeted treatment. Causes include viral infections, autoimmune diseases, post-cardiac injury syndrome, and...
313
Myocarditis II: Clinical Features and Diagnostic Tests
267
Myocarditis is an inflammation of the heart muscle. The symptoms vary widely, encompassing asymptomatic presentations to severe, acute manifestations.Clinical PresentationAsymptomatic cases: In some instances, myocarditis may be asymptomatic, with the infection resolving without intervention. These cases often go undetected unless discovered incidentally through diagnostic imaging or tests conducted for other reasons.General Early Symptoms: Early symptoms of myocarditis are non-specific and can...
267
Rheumatic Heart Disease III: Medical Management
289
Rheumatic heart disease (RHD) management can be divided into two main strategies: prevention and long-term management.Primary PreventionPrimary prevention focuses on timely diagnosis and management of group A streptococcal pharyngitis to prevent acute rheumatic fever. The most widely used antibiotic for treating this condition is intramuscular benzathine penicillin G.Acute Rheumatic Fever TreatmentThe primary treatment goal for a patient diagnosed with acute rheumatic fever is to suppress the...
289
Myocarditis I: Introduction
374
Myocarditis is inflammation of the myocardium, which is the muscular layer of the heart.EtiologyMyocarditis has a diverse etiology, including a wide range of infectious and non-infectious causes:Infectious CausesViral: Common viruses include Coxsackie A and B, adenovirus, parvovirus B19, enteroviruses, and influenza A.Bacterial: Examples include infections caused by Streptococcus, Staphylococcus, and Mycoplasma species.Rickettsial: Infections like Rocky Mountain spotted fever can result in...
374


